Locals Drug Chart Flashcards by Theresa Le

What is the onset time for Lidocaine?

Rapid

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What is the duration of Lidocaine’s effect?

1–2 hours

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What is the maximum dose of Lidocaine without epinephrine?

4.5 mg/kg (300 mg)

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What is the maximum dose of Lidocaine with epinephrine?

7 mg/kg (500 mg)

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What are the key notes about Lidocaine?

Moderate potency, low cardiovascular (CV) toxicity, versatile (topical, IV, spinal, epidural)

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What is the onset time of Prilocaine?

Rapid

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What is the duration of Prilocaine?

1–2 hours

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What is the maximum dose of Prilocaine?

600 mg

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What are the notes regarding Prilocaine?

Similar to lidocaine, causes less vasodilation; risk of methemoglobinemia

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What is the onset time of Mepivacaine?

Intermediate

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What is the duration of Mepivacaine?

2–4 hours

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What is the maximum dose of Mepivacaine without epinephrine?

7 mg/kg (400 mg)

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What is the maximum dose of Mepivacaine with epinephrine?

500 mg

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What are the notes regarding Mepivacaine?

Slightly longer duration than lidocaine; not preferred in obstetrics

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What is the onset time of Ropivacaine?

Intermediate

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What is the duration of Ropivacaine?

2–6 hours

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What is the maximum dose of Ropivacaine?

3 mg/kg (200 mg)

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What are the notable characteristics of Ropivacaine?

Less lipid-soluble than bupivacaine; less motor block, less cardiotoxic

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What is the onset time of Etidocaine?

Rapid

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What is the duration of Etidocaine?

4–12 hours

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What is the maximum dose of Etidocaine no epi?

300 mg

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What is the maximum dose of Etidocaine when used with epinephrine?

400 mg

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What are the notable characteristics of Etidocaine?

Very potent, dense motor block, rapid onset

What is the onset time of Bupivacaine?

Slow (except in spinal)

What is the duration of Bupivacaine?

4–12 hours

What is the maximum dose of Bupivacaine without epinephrine?

2.5 mg/kg (175 mg)

What is the maximum dose of Bupivacaine with epinephrine?

3 mg/kg (200 mg)

What are the key characteristics of Bupivacaine?

High potency, cardiotoxic, long-acting, dense motor block, used for continuous & post op OB

What is the onset time of Levobupivacaine?

Slow

What is the duration of Levobupivacaine?

4–12 hours

What is the maximum dose of Levobupivacaine?

2 mg/kg (150 mg)

What is a notable characteristic of Levobupivacaine?

S-enantiomer of bupivacaine, less toxic, similar duration and potency

What is the onset time of Chloroprocaine?

Rapid

What is the duration of Chloroprocaine?

30–60 minutes

What is the maximum dose of Chloroprocaine without epinephrine?

11 mg/kg (800 mg)

What is the maximum dose of Chloroprocaine with epinephrine?

14 mg/kg (1000 mg)

What are the key notes about Chloroprocaine?

Very rapid metabolism, low toxicity, commonly used in OB epidurals

What is the onset time of Benzocaine?

Rapid

What is the duration of action for Benzocaine?

30–60 minutes

What is the maximum dose of Benzocaine?

200 mg

What are the important notes regarding Benzocaine?

Topical only; high risk of methemoglobinemia, especially in neonates

What is the onset time for cocaine?

Rapid

What is the duration of cocaine's effects?

Short

What is the maximum dose of cocaine?

150 mg

What are the notes regarding cocaine use?

Topical use only; causes intense vasoconstriction, high toxicity and abuse risk

What is the onset time of Procaine?

Slow

What is the duration of Procaine?

30–60 minutes

What is the maximum dose of Procaine?

7 mg/kg (350–600 mg)

What are the notes regarding Procaine?

Weak, short-acting; mostly obsolete except for some spinal/infiltration uses

What is the onset time of Tetracaine?

Slow

What is the duration of Tetracaine?

2–3 hours (up to 6 hours with epi)

What is the maximum dose of Tetracaine?

20 mg

What are the key notes regarding Tetracaine?

Potent & long-acting; used in spinal & ophthalmology; high spinal toxicity if overdosed

What is the Relative potency ranking of local anesthetics?

Bupivicaine=levobupivicaine>etidocaine>ropivicaine>mepivicaine=lidcoaine=prilocaine>esters FOOTNOTE** Mnemonic: “Big Lions Eat Raw Meat Like Perfect Entrees” • Big – Bupivacaine • Lions – Levobupivacaine • Eat – Etidocaine • Raw – Ropivacaine • Meat – Mepivacaine • Like – Lidocaine • Perfect – Prilocaine • Entrees – Esters

Rank Rates of absorption from fastest to slowest

Interpleural>intercoastal>caudal>epidural>brachial plexus>sciatic/femoral>subcutaneous FOOTNOTE** More vascular areas = faster absorption = higher risk of systemic toxicity (e.g., LAST — Local Anesthetic Systemic Toxicity). Mnemonic: “I Injected Crazy Evil Bats Flying Slowly” I – Interpleural I – Intercostal C – Caudal E – Epidural B – Brachial plexus F – Femoral/Sciatic S – Subcutaneous